Prevalence and Predictors of Abnormal Liver Enzymes in Young Women with Anorexia Nervosa

Objective

To determine the prevalence and predictors of abnormal liver enzyme levels in ambulatory young women with anorexia nervosa (AN).

Study design

In this cross-sectional study of 53 females with AN, serum concentrations of liver enzymes and hormones were measured. Anthropometric, dietary, and body composition information was collected. Correlational analyses were performed between liver enzyme concentrations and these variables.

Results

Elevated alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT) levels were found in 14 subjects (26%) and 5 subjects (9%), respectively. ALT and GGT were inversely correlated with body mass index (r = −0.27 to −0.30, P < .049) and percentage body fat (r = −0.36 to −0.47, P < .007) but showed no relationship with lean body mass. Subjects with percentage body fat < 18% had higher ALT levels than those above this threshold (median 26.5 vs 18.0 U/L, P = .01). Liver enzyme concentrations did not correlate with dietary variables, except for GGT and percentage of calories from protein (r = 0.28, P = .04).

Conclusions

Serum ALT and GGT concentrations are inversely related to adiposity in young women with AN. Future studies are needed to determine whether these liver enzyme elevations signify unrecognized, clinically relevant liver disease.

Abbreviations: ALT, Alanine aminotransferase, AN, Anorexia nervosa, AP, Alkaline phosphatase, AST, Aspartate aminotransferase, BMI, Body mass index, DRI, Dietary reference intake, GGT, Gamma glutamyl transpeptidase, HOMA, Homeostasis model assessment of insulin resistance, IBW, Ideal body weight, NAFLD, Non-alcoholic fatty liver disease, T₃, Triiodothyronine, T₄, Thyroxine